نوع مقاله : مقاله های پژوهشی
نویسندگان
1 استادیار? گروه جراحی? دانشکده ی پزشکی? دانشگاه علوم پزشکی اصفهان? اصفهان?ایران
2 دانشجوی پزشکی، دانشکدهی پزشکی و کمیتهی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
چکیده
کلیدواژهها
عنوان مقاله [English]
نویسندگان [English]
Background: Traditionally, left colon obstruction is managed by a multistage defunctioning colostomy and resection. This paper presents the complications of single stage operation on a series of patients managed by primary anastomosis.Methods: In this retrospective study with the use of the patients file we gained the number of emergency patients, the number of patients under emergency sigmoid volvolus and left sided colon obstructive cancer, and left-sided colonic lacerations caused by the trauma. Complications of patients who had emergency resection and anastomosis surgery were studied.Findings: 109 patients were afflicted with left-sided colon obstruction, 25 patients (22.9%) had left sided colon obstructive cancer, 16 patients (14.7%) left sided colon lacerations caused by trauma, and 68 patients (62.4%) had emergency sigmoid volvolus. Of the 109 patients, 46 patients (42.2%) underwent resection and primary anastomosis, 25 patients (22.9%) reduction, and 38 patients (34.9%) underwent colostomy. The average age of sigmoid volvolus was 58 years, left sided colon obstructive cancer 62 years, and left-sided colon lacerations caused by trauma was 23 years. In sigmoid volvolus of the 30 patients who underwent resection and primary anastomosis 5 died (16.7%). According to the existing information, of the 25 living patients no one had wound infection, abscess, anastomotic leakage, and only 1 patient (4%) had a second surgery. In left-sided colon obstructive cancer, of the 12 patients who underwent resection and primary anastomosis 4 patients died (33.3%), and from the 8 living patients only 1 patient had (12.5%) infection wound and 1 patient (12.5%) had abscess, no patients had anastomotic leakage, and 5 patients (62.5%) need second surgery. In left-sided colon lacerations caused by trauma the 4 patients had no complications, and there were no deaths. Conclusion: Regarding the results of this study it can be concluded that left colon primary anastomosis can be performed safely in selected patients with acute obstruction of left colon.
کلیدواژهها [English]